Provider Demographics
NPI:1184824104
Name:FURGASSA, SOLMON (AA)
Entity Type:Individual
Prefix:MR
First Name:SOLMON
Middle Name:
Last Name:FURGASSA
Suffix:
Gender:M
Credentials:AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 15TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-5103
Mailing Address - Country:US
Mailing Address - Phone:415-865-3000
Mailing Address - Fax:415-865-3099
Practice Address - Street 1:101 15TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-5103
Practice Address - Country:US
Practice Address - Phone:415-865-3000
Practice Address - Fax:415-865-3099
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor